Dear Diane,
I like your analogies and believe them to be accurate. I do remember the excitement of learning new things and going out to save the world. Now it has been 23 years and I sometimes have those "oh wow" feelings, other times I am riding the waves but not going forward.  Then there are times I have to float a while.
I just take a week or two and do my job but can't really get into any "discussions" with nurses, doctors, or anybody. I just take each day as it comes. I suppose that is burnout, but I prefer to call it floating a while, because I can then get back into things and regroup. One of the best things I did was to go part time to work. Personally full time did not give me enough regrouping time and I found myself floating more and more. Many LCs do well with full time.  I have known a couple of LCs through the years who are floating along,occasionally making a small effort to swim, but generally just too exhausted to try. Trouble is, they are so tired they don't even know that they aren't on the waves anymore. The phone rings and they are too tired to answer it. I knew one LC who dumped all her phone messages at the end of the day. The patients wondered why they never got their calls returned.

You might also consider rip tides.  Rip tides are when the current goes sideways and you have to swim away from the current in a relaxed way parallel to the shoreline. If you fight the current it will exhaust you and you will drown.
When a doctor confronts you and yells about something, then you are in a riptide situation. Couple times a year I have to swim away and get to a safe place and tread water for a while until it passes. Usually over tongue tie, or cup feeding, or something the doctor has little knowledge about but wants to make a big deal over probably because they are having a bad day themselves.  I am getting better at riptides.  They used to exhaust me, I am learning to take them in stride. It has taken me a very long time. Some LCs finally get to shore after experiencing a rip tide, and walk away forever. I have a dear friend who did this. One doctor's comments ended her career. 

Conferences, networking, writing,Lactnet, being around La Leche League groups of happy mothers- these are the resources that strengthen me and keep me in the water. 

It is interesting and fun to picture a whole ocean of us. Some of us are big waves, some are little waves. All of us make a difference, one baby at a time.  

Ann Calandro, RNC,IBCLC

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